| NPI | 1861020265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME157936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01094748A) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-11-13 |